• Title, Summary, Keyword: cost-benefit analysis

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A Study on the analysis of activities of t?e 5.H.T. (5.H.T. in Pusan City) (부산지역 양호교사의 업무분석에 관한 연구)

  • Kim, Lee-Sun;Kim, Bok-Yong
    • Journal of Korean Academy of Community Health Nursing
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    • v.1 no.1
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    • pp.465-502
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    • 1989
  • The purpose of this study was to find out the general characteristics of school health teachers, the status of school health resources and the degrees of self-confident performance for the 124 school health teachers in Pusan City. Data was collected by means of questionaires from Aug. 1986 to Mar. 1987. The data were analyzed by use of percentage, mean, standard deviation, t-test, ANOVA and Pearson-correlation coefficient. The results of this study were as follows: 1 . General Characteristics of School Health Teachers (SHT) 1) The average of age of the SHT was 32.8 years old and 39.5% of them were from 30 to 34 years old. 2) The average for school nursing experience of the SHT was 7.9 years and 37.9% of them were from 5 to 9 years. 3) The 45.2% of them have not the clinical experience. 4) The 74.2% of them were graduated from the 3 years college of nursing. 2. Status of school health resources and nursing activities. 1) The average of student number was 2497.3 and class number was 45.2. 2) The average of school health budget was 1039000 won and 27.7% of school health budget expended on examination cost. 3) Only 29.0% of all schools have organization for school health. 4) The 84.7% of all schools have health clinic separately and 69.1% of schools have less than $33m^2$ sized. 5) The average of clinic visitor number was 2111.8 for 1 year. 6) Major problem was on digestive system. And other problems were skin, respiratory, musculo-skeletal system and dental problem. 7) The number of literal message was 14.4 times for 1 year. 3. The degree of the school health teachers' self-confidence. The school health teachers' self-confidence was deviced into 6 and the maximum degree was 4. 1) Program planning & evaluation; 2.8 2) Clinic management; 2.9 3) Health education, 3.0 4) Management of school environment; 2.7 5) Health care services; 2.7 6) Operating of school health organization; 2.4 4. Significances to the degree of self-confidence on school health nursing activities. 1) There was significant difference between clinical management and Religion (t=2.15 p<.05) 2) There was significant difference between Operating of school health organization and level of school (F=3.588 p<.05) 3) Program planning & evaluation: expending time for clinical management (r=-0.184 p<.05) expending time for health care services (r=0.273 p<.01) 4) Clinical management: use of separate health clinic (r=0.151 p<.05) 5) Health education: use of separate health clinic (r=0.170 p<0.5) 6) Health care services: No. of student (r=-0.144 p<0.5) No. of class (r=-0.160 p<.05) 5. The degree of the school health teachers' self-discipline. The school health teachers' self-discipline was devided into 2 and the maximum degree was 2. 1) Program planning & evaluation:1.8 2) Clinic management: 1.9 3) Health education: 1.9 4) Management of school environment: 1.7 5) Health care services: 1.8 6) Operating of school health organization.: 1.3 6. Significances to the degree of self-discipline on school health nursing activities 1) Program planning & evaluation; Level of nursing education (F=4.309 p<.01) 2) Clinical management: Level of nursing education (F=3.587 p<.05) 3) Operating of school health organization: School health organization (t=-2.68 p<.01) 4) Health care services: School health organization (t=2,58 p<.05) 5) School health performance: School health organization (t=2.32 p<.05) 6) Program planning & evaluation: School health experience (r=0.239 p<.01) Expending time for program planning & evaluation (r=-0.172 p<.05) 7) Clinic management: School health experience (r=0.249 p<.01) Expending time for dinic management (r=0.181 p<.05) No. of student (r=-0.158 p<.05) Expending time of program planning & evaluation (r=-0.199 p<0.5) 8) Health education: School health experience (r=0.234 p<0.1) Expending time of program planning & evaluation (r=-0.193 p<.05) 9) Management of school environment: Age of school health teacher (r=0.142 p<.05) School health experience (r=0.255 p<.01) 10) Operating of school health organization: Medicine Purchase (r=-0.163 p<.05) 11) Health care services: School health experience (r=0.148 p<.05) Medicine purchase (r=-0.229 p<.01) 12) Total school health performance: School health experience (r=0.200 p<.05) Medicine purchase(r=-0.168 p<.05) Based on the above results, the suggestions are as follows: 1) As the SHT take charge of the reasonable number of student, the students will have benefit of the good health service in quality. 2) It is recommended to use the health clinic separately and to arrange adequate place for good school health service. 3) It is necessary that the SHT participate budget for school health. 4) It is required to enhance self-confidence on school health nursing activities through continuous educational programs.

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PM2.5 Simulations for the Seoul Metropolitan Area: (II) Estimation of Self-Contributions and Emission-to-PM2.5 Conversion Rates for Each Source Category (수도권 초미세먼지 농도모사 : (II) 오염원별, 배출물질별 자체 기여도 및 전환율 산정)

  • Kim, Soontae;Bae, Changhan;Yoo, Chul;Kim, Byeong-Uk;Kim, Hyun Cheol;Moon, Nankyoung
    • Journal of Korean Society for Atmospheric Environment
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    • v.33 no.4
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    • pp.377-392
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    • 2017
  • A set of BFM (Brute Force Method) simulations with the CMAQ (Community Multiscale Air Quality) model were conducted in order to estimate self-contributions and conversion rates of PPM (Primary $PM_{2.5}$), $NO_x$, $SO_2$, $NH_3$, and VOC emissions to $PM_{2.5}$ concentrations over the SMA (Seoul Metropolitan Area). CAPSS (Clean Air Policy Support System) 2013 EI (emissions inventory) from the NIER (National Institute of Environmental Research) was used for the base and sensitivity simulations. SCCs (Source Classification Codes) in the EI were utilized to group the emissions into area, mobile, and point source categories. PPM and $PM_{2.5}$ precursor emissions from each source category were reduced by 50%. In turn, air quality was simulated with CMAQ during January, April, July, and October in 2014 for the BFM runs. In this study, seasonal variations of SMA $PM_{2.5}$ self-sensitivities to PPM, $SO_2$, and $NH_3$ emissions can be observed even when the seasonal emission rates are almost identical. For example, when the mobile PPM emissions from the SMA were 634 TPM (Tons Per Month) and 603 TPM in January and July, self-contributions of the emissions to monthly mean $PM_{2.5}$ were $2.7{\mu}g/m^3$ and $1.3{\mu}g/m^3$ for the months, respectively. Similarly, while $NH_3$ emissions from area sources were 4,169 TPM and 3,951 TPM in January and July, the self-contributions to monthly mean $PM_{2.5}$ for the months were $2.0{\mu}g/m^3$ and $4.4{\mu}g/m^3$, respectively. Meanwhile, emission-to-$PM_{2.5}$ conversion rates of precursors vary among source categories. For instance, the annual mean conversion rates of the SMA mobile, area, and point sources were 19.3, 10.8, and $6.6{\mu}g/m^3/10^6TPY$ for $SO_2$ emissions while those rates for PPM emissions were 268.6, 207.7, and 181.5 (${\mu}g/m^3/10^6TPY$), respectively, over the region. The results demonstrate that SMA $PM_{2.5}$ responses to the same amount of reduction in precursor emissions differ for source categories and in time (e.g. seasons), which is important when the cost-benefit analysis is conducted during air quality improvement planning. On the other hand, annual mean $PM_{2.5}$ sensitivities to the SMA $NO_x$ emissions remains still negative even after a 50% reduction in emission category which implies that more aggressive $NO_x$ reductions are required for the SMA to overcome '$NO_x$ disbenefit' under the base condition.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Development of GIS based Water Quality Simulation System for Han River and Kyeonggi Bay Area (한강과 경기만 지역 GIS 기반 통합수질모의 시스템 개발)

  • Lee, Chol-Young;Kim, Kye-Hyun
    • Journal of Korea Spatial Information System Society
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    • v.10 no.4
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    • pp.77-88
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    • 2008
  • There has been growing demands to manage the water quality of west coastal region due to the large scale urbanization along the coastal zone, the possibility of application of TMDL(Total Maximum Daily Loadings) to Han river, and the natural disaster such as oil spill incident in Taean, Chungnam. However, no system has been developed for such purposes. In this background, the demand of GIS based effective water quality management has been increased to monitor water quality environment and propose best management alternatives for Han river and Kyeonggi bay. This study mainly focused on the development of integrated water quality management system for Han river bas in and its estuary are a connected to Kyeonggi bay to support integrated water quality management and its plan. Integration was made based on GIS by spatial linking between water quality attributes and location information. A GIS DB was built to estimate the amount of generated and discharged water pollutants according to TMDL technical guide and it included input data to use two different water quality models--W ASP7 for Han river and EFDC for coastal area--to forecast water quality and to suggest BMP(Best management Practices). The results of BOD, TN, and TP from WASP7 were used as the input to run EFDC. Based on the study results, some critical areas which have relatively higher pollutant loadings were identified, and it was also identified that the locations discharging water pollutant loadings to river and seasonal factor affected water quality. And the relationship of water quality between river and its estuary area was quantitatively verified. The results showed that GIS based integrated system could be used as a tool for estimating status-quo of water quality and proposing economically effective BMPs to mitigate water pollution. Further studies need to be made for improving system's capabilities such as adding decision making function as well as cost-benefit analysis, etc. Also, the concrete methodology for water quality management using the system need to be developed.

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A Study on Ensuring Biosafety of Biotechnology Product under Debate about Trade and the Environment (DDA 무역-환경 논의와 생명공학제품의 안전성 확보)

  • Sung, Bong-Suk;Yoon, Ki-Kwan
    • Environmental and Resource Economics Review
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    • v.13 no.3
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    • pp.519-547
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    • 2004
  • This paper analyze problems about scope of specific trade obligations(STOs), principle of dispute settlement procedure, and non-parties in context of the Cartagena Protocol on Biosafety(POB), which based on sub-paragraph 31(i) of DDA WTO Ministrial Declaration. The implications based on result of this study are as follows. First, to accept the wider scope of STOs under POB in Korea, importing country, won't be harmful to LMOs and Bioindustry. Instead, it will ensure a high level of biosafety concerning the import of LMOs. Exporters can take different kinds of trade measures to countervail adverse effect on the export of LMOs in this case. Therefore importer will endure the aftereffect. However, if korea were in exporter's place, to accept the wider scope STOs under POB will not have a good influence on the export of LMOs. Korea, therefore, should devise scheme for responding to debate about the STOs in MEAs, which have to be based on cost-benefit analysis and scenarios taking into account of speed and level in biotechology progress, status and trend of LMOs R&D and production, and condition of other industries. Second, it is not easy to agree with applying to what's rule between the POB and WTO for settlement dispute. Because there is the incompatibility between the POB characterized according to social rationality and WTO's rules for safety and environmental protection characterized according to scientific rationality. This issue have to be discussed for long period due to gap like that. Accordingly Korea, one of major LMOs importing countries, should suggest continuously that the effort is needed to ensure an adequate level of protection in transboundary movements of LMOs and scientific, environmental and socio-economic study. Third, in case of dispute between party and non-party of the POB, the duties under the WTO of non-party of the POB(if WTO member country) is valid. The country, therefore, will try to settle dispute based on WTO's rules. However, international society have to ensure for sound and safe use of LMOs in the field of transboundary movements. Accordingly Korea should devise scheme for preventing the possibility of dispute between party and non-party of the POB(if WTO member country), which is supported by policy options under the POB.

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An Analysis on the Conditions for Successful Economic Sanctions on North Korea : Focusing on the Maritime Aspects of Economic Sanctions (대북경제제재의 효과성과 미래 발전 방향에 대한 고찰: 해상대북제재를 중심으로)

  • Kim, Sang-Hoon
    • Strategy21
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    • pp.239-276
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    • 2020
  • The failure of early economic sanctions aimed at hurting the overall economies of targeted states called for a more sophisticated design of economic sanctions. This paved way for the advent of 'smart sanctions,' which target the supporters of the regime instead of the public mass. Despite controversies over the effectiveness of economic sanctions as a coercive tool to change the behavior of a targeted state, the transformation from 'comprehensive sanctions' to 'smart sanctions' is gaining the status of a legitimate method to impose punishment on states that do not conform to international norms, the nonproliferation of weapons of mass destruction in this particular context of the paper. The five permanent members of the United Nations Security Council proved that it can come to an accord on imposing economic sanctions over adopting resolutions on waging military war with targeted states. The North Korean nuclear issue has been the biggest security threat to countries in the region, even for China out of fear that further developments of nuclear weapons in North Korea might lead to a 'domino-effect,' leading to nuclear proliferation in the Northeast Asia region. Economic sanctions had been adopted by the UNSC as early as 2006 after the first North Korean nuclear test and has continually strengthened sanctions measures at each stage of North Korean weapons development. While dubious of the effectiveness of early sanctions on North Korea, recent sanctions that limit North Korea's exports of coal and imports of oil seem to have an impact on the regime, inducing Kim Jong-un to commit to peaceful talks since 2018. The purpose of this paper is to add a variable to the factors determining the success of economic sanctions on North Korea: preventing North Korea's evasion efforts by conducting illegal transshipments at sea. I first analyze the cause of recent success in the economic sanctions that led Kim Jong-un to engage in talks and add the maritime element to the argument. There are three conditions for the success of the sanctions regime, and they are: (1) smart sanctions, targeting commodities and support groups (elites) vital to regime survival., (2) China's faithful participation in the sanctions regime, and finally, (3) preventing North Korea's maritime evasion efforts.